The National Health Plan Collaborative: Overview of Its Origins, Accomplishments, and Lessons Learned
Overview of Key Points
The National Health Plan Collaborative (NHPC) was formed in 2004 to bring large national and regional health plans together to reduce racial and ethnic disparities. The Agency for Healthcare Research and Quality (AHRQ) and the Robert Wood Johnson Foundation (RWJF) cosponsored the NHPC. The NHPC's goal was to provide a forum for health plans to better understand disparities and share strategies and best practices for measuring disparities and developing interventions to reduce them.
From the NHPC's inception, collaboration was a primary objective of participants. Sponsors supported this goal based on the perception that such collective action and engagement on the issue of health care disparities would heighten its prominence and encourage participating health plans (and indirectly the insurance industry overall) to appreciate why disparities are an issue. This could in turn lead to creative approaches to measuring and reducing such disparities. Outside sponsorship from leading independent public- and private-sector sponsors also was considered essential by many participants, particularly in the NHPC's first few years, when the importance of and approaches to examining disparities among plan members were less clear.
In the 5 years after the NHPC's inception, most participating firms evolved from having little experience collecting race and ethnicity data and measuring quality of care by race and ethnicity, to embracing and institutionalizing disparities measurement and reduction activities. While AHRQ's sponsorship of the NHPC ended in fall 2008, NHPC plans still are participating in disparities reduction activities under the direction of America's Health Insurance Plans (AHIP) and are using this new forum to share their expertise with other AHIP member plans.
The organizational context of participating firms in the NHPC was important to how the collaborative developed and progressed. The firms that participated in the NHPC are large, complex organizations. Change in these organizations typically occurs slowly, and competing demands and pressures within each firm often slowed progress—an important lesson for NHPC sponsors. That said, the NHPC did become more effective in setting and meeting its goals over time through the decision to focus on a few priority areas on which NHPC participants agreed.
Through their work on the NHPC, firms have become more committed to work on disparities and have modified their organizational structures to institutionalize such concerns. The NHPC enhanced communication and information sharing across firms in the industry and generated an increased appreciation among public and private partners about their concerns and the factors driving their organizations. AHRQ's sponsorship of the NHPC thus can be viewed as a timely investment that has generated knowledge, commitments, and channels of communication that provide a valuable basis for future work on disparities.
This brief summarizes our findings from the evaluation of the NHPC.i We first provide background on the NHPC, including its beginnings, the way its work was divided across two phases (2004-2006 and 2006-2008), and where the NHPC stands currently. We then discuss what the evaluation sought to achieve, along with its main findings, focusing first on overarching accomplishments related to disparities and then on accomplishments on specific activities. Next, we describe the NHPC toolkit—;the main vehicle through which the group disseminated its Phase II work. We conclude with a discussion of the broader lessons learned from the NHPC and how these are relevant both to disparities in general and to other policy issues in which public/private collaboration may be relevant.
i The evaluation was funded by AHRQ. Our findings are based on observations of all NHPC meetings and call, a review of the documents generated for the meetings and calls, and periodic telephone discussions that evaluation staff conducted in confidence with each firm, support organization, and sponsor involved in the NHPC.